1.Syndrome of inappropriate ADH secretion following secondary haploidentical stem cell transplantation after graft failure of umbilical cord blood transplantation:a case report and literature review
Maojing GUAN ; Liangquan GENG ; Huilan LIU ; Xingbing WANG ; Juan TONG ; Zimin SUN
Journal of Leukemia & Lymphoma 2013;22(10):612-614,628
Objective To study the syndrome of inappropriate ADH secretion(SIADH)after all ogeneic hematopoietic stem cell transplantation(allo-HSCT)and the possible etiology.Methods SIADH was occurred in one patient with acute lymphoblastic leukemia who received secondary haploidentical stem cell transplantation after graft failure following umbilical cord blood transplantation.Results An 11-year-old boy was diagnosed as high-risk acute lymphoblastic leukemia,and the transplantation of unrelated double umbilical cord blood was performed for the first time,however,there was no engraftment at 28 days after the first transplantation.Secondary haploidentical stem cell transplantation was administered at day 33 after the first transplantion.The bone marrow and the peripheral blood stem cells from the patient's father transplantation was adopted.Pre-engraftment syndrome was developed in the patient at day 7 after secondary haploidentical HSCT followed by severe hyponatraemia(lowest serum sodium 115.8 mmol/L),natriuresis,hypo-osmolality of plasma,and twitch at day 26 after allo-HSCT.Then SIADH was diagnosed.The clinical condition was improved after restriction of water and administration of hypertonic saline,and eventually SIADH was controlled completely.By now,the patient had lived free of disease more than one year,with a normal diet and serum sodium in normal ranges.Conclusions SIADH after allo-HSCT is a rare fatal acute complication of central nervous system,whic h are probably associated with numerous transplant-related causes.Early accurate diagnosis and treatment promptly are great importance.
2.Evidence-based practice of early ambulation after radiofrequency catheter ablation via femoral artery
Shaoling LI ; Xiaohong LU ; Liyan WANG ; Lili WEI ; Jian HU ; Yunxia ZHAO ; Shaoshao WANG ; Lili XIA ; Maojing WANG
Chinese Journal of Modern Nursing 2021;27(31):4288-4293
Objective:To form an evidence-based practice standard for early ambulation after radiofrequency catheter ablation via femoral artery (RFCA) , so as to improve the awareness of nurses' evidence and the rate of clinical practice standards, and reduce the incidence of patient complications.Methods:Totals of 2 evidence summaries, 4 systematic reviews and 2 guidelines were included through searching domestic and foreign databases. The innovation-Promoting Action on Research Implementation in Health Services (i-PARIHS) was used to analyze the obstacles to the application of evidence and formulate available solutions. From June 2019 to November 2020, convenience sampling was used to select 180 patients who underwent RFCA and 39 nurses in the Department of Cardiovascular of the Affiliated Hospital of Qingdao University for evidence-based.Results:A standardized procedure and evaluation record form for the guidance of ambulation after RFCA were formed, and the nursing norms after RFCA were updated. After 2 rounds of evidence application, the awareness and implementation rates of the nurses' review indicators increased, and the differences were statistically significant ( P<0.01) . After 2 rounds of evidence application, the patients' low back pain score and anxiety score were lower than those before the evidence application, and the differences were statistically significant ( P<0.01) . The incidence of dysuria and the vagus nerve firing in patients were lower than those before the evidence application, and the differences were statistically significant ( P<0.05) . Conclusions:The development of this evidence-based project promotes early postoperative ambulation of patients and reduces the incidence of complications.